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Eur J Cardiothorac Surg 2007;31:381-382. doi:10.1016/j.ejcts.2006.12.022
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Editorial comment

Functional assessment of bypass grafts by fractional flow reserve

Catharina Hospital, Department of Cardiology, Eindhoven, The Netherlands

^_* Corresponding author. Tel.: +31 40 2397004; fax: +31 40 2447885. (Email: nico.pijls@inter.nl.net).

The first 20% of the full text of this article appears below.

In an interesting paper published in the present issue of the journal, Glineur et al. describe systematic measurements of fractional flow reserve in coronary bypass grafts [1]. These data are important because they tell us more about the function of normal grafts both at rest and during maximum hyperemia, corresponding with physiologic exercise in true life.

Fractional flow reserve (FFR) is the gold standard for functional assessment of coronary arteries. It is an index which is exclusively calculated during maximum coronary and myocardial hyperemia and expresses maximum achievable blood flow in a particular conduit (native or graft) as a fraction of normal maximum blood flow to the same myocardial territory in case the patient would be completely healthy [2,3].

FFR can be easy calculated during cardiac catheterization by the ratio of distal coronary pressure (or distal bypass graft pressure) compared to aortic pressure after administration of a sufficient hyperemic stimulus, mostly adenosine.

In normal coronary arteries, fractional flow reserve equals 1.0 even under conditions of maximum hyperemia [4]. This indicates that resistance in a normal coronary artery is negligible. A value of FFR < 0.75 indicates inducible ischemia with a specificity and sensitivity . . . [Full Text of this Article]

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				M. Poullis and R. Warwick Fractional flow reserve of pedicled left and right internal thoracic arteries Eur. J. Cardiothorac. Surg., September 1, 2007; 32(3): 555 - 556. [Full Text] [PDF]